Background—The cause of inflammatory bowel disease (IBD) is unknown, and it is often difficult to obtain diagnostic histological specimens. In considering the diagnosis of IBD, other causes of enteritis should be excluded. We present a case that illustrates this.

Case report—A 32 year old man presented with a history of intermittent diarrhoea, vomiting, colicky abdominal pain, and weight loss. There was no history of foreign travel or recent contact with gastroenteritis, and he had no family history or past medical history of note. On examination, he was a pale thin man with central abdominal tenderness; other systems were unremarkable. Abnormal blood tests included a raised white cell count 20.4 × 10⁶/l (normal 4–11 × 10⁶), C-reactive protein (CRP) 246 …